Above average — CMS composite of the measures below.
A standard survey is most likely before around August 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Mackinac Straits Long Term Care Unit during CMS and state inspections, most recent first.
A resident who required maximal assistance for transfers was transported in a facility van without a seatbelt or appropriate safety restraint, as none was available to fit her wheelchair. During the trip, the van hit a bump, causing the resident to slide out of her wheelchair and sustain a fractured femur, requiring hospitalization and surgery. Staff were aware of the lack of a suitable safety device, and facility policy requiring seatbelt use during transport was not followed.
A facility failed to prevent and document pressure injuries for two residents, resulting in harm. One resident developed Stage 2 pressure injuries due to delayed interventions, while another had a Stage 3 pressure ulcer with inconsistent documentation. The facility did not follow its policy for weekly skin assessments and care plan updates, as acknowledged by the DON.
The facility failed to ensure accurate MDS assessments for two residents, leading to documentation errors. One resident's stage III pressure ulcer was incorrectly documented as facility-acquired, despite being present on admission. Another resident's MDS failed to indicate the use of an indwelling urinary catheter, despite medical records confirming its necessity. The DON acknowledged these errors, attributing them to incorrect coding by the MDS nurse.
A resident was injured when a bath lift tipped over during a transfer, resulting in a laceration requiring sutures. The resident, who was on a blood thinner, was being transported by bath aides when the lift tipped, despite being within the weight limit. The facility's investigation could not determine the cause, labeling it a freak accident.
Failure to Provide Safe Transport and Adequate Supervision During Resident Van Transfer
Penalty
Summary
A deficiency occurred when a resident, who required substantial to maximal assistance for mobility and transfers and had intact cognition, was transported to an outside appointment in a facility van while seated in her wheelchair. The resident's wheelchair was secured using tie-downs, but no seatbelt or safety belt was provided, as the facility did not have a device that would fit her wheelchair. Both the CNA and the activity aide responsible for the transport were aware that no protective device was available to secure the resident during the trip. During the transport, the van encountered a bump in a construction zone, causing the resident to slide partially out of her wheelchair and strike her left knee against the back of the seat in front of her. The resident immediately complained of pain, and upon return to the facility, further assessment and x-rays revealed a fractured left femur. The resident required hospitalization and surgical repair for the injury. Interviews and documentation confirmed that the staff did not provide a seatbelt or other safety restraint for the resident during transport, despite facility policy requiring residents to be secured with a seatbelt or wheelchair seat belt. The facility was unable to provide documentation of staff training on safe transport procedures, and the investigation found that the resident's wheelchair was not rated for use in the van and could not be safely secured with available equipment.
Deficient Pressure Ulcer Care and Documentation
Penalty
Summary
The facility failed to provide timely interventions to prevent pressure injuries for a resident, resulting in the development of two Stage 2 pressure injuries. The resident, who was at moderate risk for pressure sores due to conditions such as Alzheimer's disease, Down Syndrome, and limited mobility, did not receive adequate preventive measures. The facility's documentation was incomplete, and there was a delay in implementing an air mattress, which was ordered only after the wounds had already developed. Another resident with a facility-acquired Stage 3 pressure ulcer on the right ankle did not receive comprehensive wound documentation. The resident's medical record indicated a history of multiple sclerosis and COPD, and the pressure ulcer was noted to be present on admission. However, the facility failed to document weekly wound measurements consistently, as required by the physician's order and facility policy. The Director of Nursing acknowledged the deficiencies in wound documentation and the delay in implementing preventive measures. The facility's policy required weekly skin assessments and care plan updates, which were not consistently followed, leading to the potential for worsening and delayed healing of pressure injuries for both residents.
Inaccurate MDS Assessments for Two Residents
Penalty
Summary
The facility failed to ensure accurate Minimal Data Set (MDS) assessments for two residents, leading to deficiencies in their care documentation. Resident #6 was admitted with a stage III pressure ulcer on the right ankle, which was incorrectly documented as facility-acquired in multiple MDS assessments. Despite the Director of Nursing (DON) confirming that the ulcer was present on admission and had not healed, the MDS assessments consistently misrepresented the ulcer's status. This discrepancy was highlighted during an interview with the DON, who acknowledged the incorrect coding and attributed it to an error by the MDS nurse. Resident #22's MDS assessment also contained inaccuracies, failing to document the presence of an indwelling urinary catheter, despite medical records and observations confirming its use. The resident's care plan and physician orders clearly indicated the need for a catheter due to obstructive uropathy, yet the MDS did not reflect this. The DON, upon reviewing the MDS, confirmed the error and noted that the MDS nurse, who works remotely, is involved in daily meetings but did not provide a reason for the oversight. These inaccuracies in MDS assessments highlight a failure in the facility's documentation processes.
Resident Injury Due to Bath Lift Tipping Over
Penalty
Summary
The facility failed to prevent an avoidable accident involving a resident during a bath transfer, resulting in a bath lift tipping over and causing injury. The resident, who was cognitively intact and had a history of osteoporosis, diabetes, muscle weakness, and traumatic brain injury, was being transported to the bath using a bath lift. The resident was on clopidogrel, a blood thinner, which increased the risk of bleeding. During the transfer, the bath lift tipped over, causing the resident to fall and sustain a laceration to the left shin that required sutures, as well as a minor head abrasion. The incident occurred when the bath aides were preparing to lower the resident into the tub. The resident reported feeling an imbalance on the lift before it tipped over. The Director of Nursing (DON) stated that the lift was taken out of commission for evaluation, and it was determined that the resident was too heavy for the lift, although the resident's weight was within the manufacturer's specified limit. The manufacturer's inspection found no fault with the lift, and the facility's reenactment of the incident could not determine the cause of the tip-over. Interviews with staff revealed that the bath aide followed protocol by securing the resident with a safety bar over the legs. However, the aide speculated that the resident's body weight distribution might have contributed to the lift tipping over. The facility's investigation labeled the incident as a freak accident, as they could not replicate the conditions that led to the fall.
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What surveyors actually found near you
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
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Nursing homes near St. Ignace
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Medilodge Of Cheboygan | 21.4 mi | ★★★★★ | 13 | 0 |
| Bay Bluffs-emmet County Medical Care Facility | 33.8 mi | ★★★★★ | 1 | 0 |
| The Villa At The Bay | 38.5 mi | ★★★★★ | 3 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.